Bill Text (PDF)

Washington (March 6, 2023) - Senators Edward J. Markey (D-Mass.), Chair of the Health, Education, Labor and Pensions (HELP) Subcommittee on Primary Health and Retirement Security, and Rand Paul (R-Ky.) and Representatives Donald Norcross (NJ-01) and Don Bacon (NE-02) introduced their bipartisan and bicameral Modernizing Opioid Treatment Access Act. The legislation will improve patients’ ability to access medication treatment for Opioid Use Disorder (OUD) by modernizing outdated rules, empowering board-certified physicians to prescribe methadone to patients, and allowing U.S. pharmacies to dispense methadone. 
Methadone is a type of medication treatment for OUD that is effective in helping people maintain recovery and avoid diversion. While physicians can prescribe, and pharmacies can dispense, methadone for chronic pain, methadone for opioid use disorder is only available at Opioid Treatment Programs (OTPs). OTPs can be difficult to access for many people, particularly those in rural regions, for individuals with limited access to transportation, and for patients in regions with few or no programs. Currently, there are no OTPs in Wyoming, Guam, North Marianas, the Federated States of Micronesia, and America Samoa; there is only one in South Dakota and the U.S. Virgin Islands; there are three in Nebraska; and four in Mississippi and Hawaii.

“Our communities are shouldering not just an opioid crisis but also an overdose crisis. Parents are losing their children. Children are losing their parents. Yet, we are still making recovery harder with outdated rules that burden the very people we need to be providing care for,” said Senator Markey. “In too many states across the country, every morning people have to travel for miles and miles to reach a clinic—if there’s one around at all—where they line up behind other patients waiting to get the medication they need. If we want to beat these crises, we have to meet people where they are at with the resources they need. The Modernizing Opioid Treatment Access Act will reduce stigma and save lives.”

"As a physician, I know the value of the doctor-patient relationship. This bipartisan legislation will return treatment decisions to health care providers, who know their patients best. Doing so will be another important step toward combating the opioid epidemic that has caused so much harm in Kentucky and our nation,” said Dr. Paul.

“Improving access to treatment saves lives, period,” said Representative Norcross, lead sponsor of the House bill. “This legislation lowers barriers to care at a time when we are still suffering staggering losses due to the ongoing opioid epidemic. We must end the monopoly on this life-saving medicine that only serves to enrich a cartel of for-profit clinics and stigmatize patients.”

“There are only six certified methadone clinics in Nebraska, making it a significant obstacle for those seeking treatment to overcome their opioid addiction,” said Representative Bacon. “The current law requires patients to visit a clinic daily, which is not physically possible outside of the Omaha/Lincoln metro areas. It’s time make the treatment for opioid addiction more accessible than opioids themselves.” 

Senate cosponsors include Senators Bernie Sanders (I-Vt.), Mike Braun (R-Ind.), Cory Booker (D-N.J.), and Maggie Hassan (D-N.H.).

House cosponsors include Representatives Ann Kuster (NH-02), David Trone (MD-06), Brian Fitzpatrick (PA-01), Paul Tonko (NY-20), Brittany Pettersen (CO-07), and Andy Kim (NJ-03).

In addition to expanding access to medication treatment, the Modernizing Opioid Treatment Access Act would also require the Substance Abuse and Mental Health Services Administration and Drug Enforcement Administration to provide an annual report of the number of providers registered to prescribe methadone, patients prescribed methadone for OUD, and a list of states where physicians are registered to prescribe methadone.

Endorsers of the Modernizing Opioid Treatment Access Act include Addiction Professionals of North Carolina, AIDS United, Alabama Society of Addiction Medicine, American College of Academic Addiction Medicine (ACAAM), American Osteopathic Academy of Addiction Medicine, American Society of Addiction Medicine (ASAM), American Society of Health System Pharmacists, Association of Virgin Islands Psychologists, Behavioral Health Association of Providers, California Consortium of Addiction Programs & Professionals, End Substance Use Disorder, Faces & Voices of Recovery, Global Health Advocacy Incubator, Grayken Center for Addiction at Boston Medical Center, Hampshire HOPE, Kennedy Forum, Massachusetts Health and Hospital Association (MHA), Massachusetts Medical Society, Massachusetts Society of Addiction Medicine (MASAM), National Coalition to Liberate Methadone, New Jersey Hospital Association, New York Society of Addiction Medicine, Northampton, Massachusetts Department of Health and Human Services, Opioid Task Force of Franklin County and the North Quabbin Region (MA), Partnership to End Addiction, Rhode Island Society of Addiction Medicine, Shatterproof, SMART Recovery, Tapestry Health Systems Inc. (MA), The National Safety Council, The Village Virgin Islands Partners in Recovery, Young People in Recovery, Virgin Islands Board of Pharmacy, Oregon Society of Addiction Medicine, AMERSA (The Association for Multidisciplinary Education and Research in Substance use and Addiction), Connecticut Certification Board, and the National Alliance for Medication Assisted Recovery (NAMA Recovery). 

“The treatment of opioid use disorder with methadone has a long history and robust scientific evidence supporting its effectiveness, but U.S. federal law limits its availability to heavily regulated and commonly inaccessible opioid treatment programs – a structure that has implications for access to, and quality of, care. The Modernizing Opioid Treatment Access Act represents a thoughtful expansion of access to a life-saving, effective medication for many Americans with opioid use disorder,” said William F. Haning, MD, DLFAPA, DFASAM, President of the American Society of Addiction Medicine. 

“Massachusetts hospitals and health systems are proud to support this legislation as they continue to use every resource in their reach to combat an intensifying opioid crisis. This proposal would enhance that set of tools by helping providers reach patients where they are, and by expanding access to treatment that has saved countless lives to date. MHA applauds Senator Markey for his leadership on this critical issue,” said Leigh Simons Youmans, Senior Director of Healthcare Policy at Massachusetts Health & Hospital Association.

“Methadone is an effective, life-saving medication that is one of the best ways to prevent overdose deaths, including from fentanyl. But for decades, federal barriers have made it difficult — and sometimes impossible — to receive. The Overdose Prevention Initiative is proud to support the Modernizing Opioid Treatment Access Act and thanks Senator Markey and the other cosponsors for their support of this transformative policy,” said Libby Jones, Program Director of the Overdose Prevention Initiative.

“Methadone is the most important treatment in the deadly fentanyl era. It is time to end the ‘liquid handcuffs’ and carceral control of this highly evidenced and effective treatment. Methadone should be treated like all other medications. As a frontline addiction doctor who runs several methadone clinics, I am grateful to Senator Markey for his leadership and courage to improve the lives of patients and decrease overdose deaths throughout our nation,” said Ruth A. Potee, MD, Medical Director at the Behavioral Health Network and Medical Director at the Franklin County Sheriff’s Office.

“Methadone has for decades been an effective and reliable tool in our effort to promote recovery from substance use disorders. As our country struggles with an overdose crisis, we should examine every possible option to expand the use of this medication. This legislation will go a long way towards destigmatizing methadone and increasing access. Faces & Voices of Recovery endorses this legislation without reservation, and we hope it will truly make a difference in assisting those in recovery,” said Patty McCarthy, CEO of Faces and Voices of Recovery.

In February, the Department of Defense outlined its plan to improve prevention of fatal opioid overdoses at military bases after Senator Markey sent a letter to the Department expressing concern regarding the fatal overdoses among active duty service members. In December 2022, Senator Markey secured his bipartisan Opioid Treatment Access Act (OTAA)—legislation that reduces wait times for patients qualifying for methadone medication treatment and expands access to methadone clinics—into the end-of-year omnibus spending package. That same month, Senator Markey also applauded proposed changes by the Department of Health and Human Services to remove barriers to OUD treatment, such as allowing people to take home doses of methadone medication, which are key provisions included in the OTAA.